The Role of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Maps in Characterization of Solid Renal Lesions

Authors : Kıymet Tokat, Türkan Ikizceli

Pages : 138-144

Doi:10.38175/phnx.806582

View : 198 | Download : 749

Publication Date : 2020-11-01

Article Type : Research Paper

Abstract :Objectives: The purpose of this study was to evaluate the added value of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) in distinguishing between benign from malignant solid renal lesions. Material and Method: A total of forty-seven patients (age range: 33-84, mean: 59.0± 11.3 years, 27 men, 20 women) with solid renal lesions detected on abdominal MR were included in our study group. The ADCs were calculated from DWI data of two different b values (b=600 mm²/s and b=1000 mm²/s). ADC values for both normal renal parenchyma and solid renal lesions were obtained. Subsequently, ROI analysis was performed to identify threshold ADCs. In all cases, the histopathological data were obtained and correlated. Results: The histopathological outcome comprises 13 benign and 34 malignant solid renal lesions. The solid malignant lesions were Renal Cell Carcinoma subtypes (1 chromophobe cell, four papillary cells, 25 clear cells), 2 Transitional Cell carcinomas, one metastasis, 1 Non-Hodgkin lymphoma. The benign solid renal lesions consisted of 2 oncocytomas and 11 angiomyolipomas. The mean ADC value of malignant lesions was 1,33 x 10-3 mm²/s, benign masses for oncocytomas 1,76 x 10-3 mm²/s, and angiolipomas 1,28 x 10-3 mm²/s respectively (p<0.001). The mean ADC value of normal renal parenchyma was 2,22 x 10-3 mm²/s, and the mean ADC value of benign and malignant masses without discrimination was 1.34 x 10-3 mm²/s (p <0.001). Conclusion: ADC values can be a useful parameter to differentiate malignant solid renal lesions in renal masses. Also, significant differences in ADC values among RCC subtypes indicate the availability of ADC in RCC subtype determination.
Keywords : böbrek kitleleri, manyetik rezonans görüntüleme, difüzyon ağırlıklı görüntüleme, görünen difüzyon katsayısı